Motivational Interviewing in Health Care: Helping Patients Change Behavior

by Stephen Rollnick PhD, William R. Miller PhD, Christopher C. Butler MD

Overview

The definitive guide to motivational interviewing (MI) for health care practitioners has been completely revised to reflect important developments and make the approach even more accessible. When it comes to helping patients manage chronic and acute conditions and make healthier choices in such areas as medication adherence, smoking, diet, and preventive care, good advice alone is not enough. This indispensable book shows how to use MI techniques to transform conversations about change. Even the briefest clinical interaction can serve to build trust, clarify patients' goals as well as reasons for ambivalence, and guide them to take positive steps. Vivid sample dialogues, tips, and scripts illustrate ways to incorporate this evidence-based approach into diverse health care settings.
 
New to This Edition
*Restructured around the four processes of MI (engaging, focusing, evoking, and planning).
*Incorporates lessons learned from the authors' ongoing clinical practice and practitioner training workshops.
*Chapters on advice-giving, brief consultations, merging MI with assessment, MI in groups, and making telehealth consultations more effective.
*Additional practical features—extended case examples, "Try This" activities, and boxed reflections from practitioners in a range of contexts.

This book is in the Applications of Motivational Interviewing series, edited by Stephen Rollnick, William R. Miller, and Theresa B. Moyers.

 

Product Details

ISBN-13:	9781462550371
Publisher:	Guilford Publications, Inc.
Publication date:	09/23/2022
Series:	Applications of Motivational Interviewing Series
Edition description:	Second Edition
Pages:	216
Sales rank:	150,844
Product dimensions:	5.90(w) x 8.90(h) x 0.80(d)

About the Author

Stephen Rollnick, PhD, is Honorary Distinguished Professor in the School of Medicine at Cardiff University, Wales, United Kingdom. He is cofounder of motivational interviewing, with a career in clinical psychology and academia that focused on how to improve conversations about change, and helped to create the Motivational Interviewing Network of Trainers (https://motivationalinterviewing.org). He has worked in diverse fields, with special interests in mental health and long-term health conditions like diabetes, heart disease, and HIV/AIDS. Dr. Rollnick has published widely in scientific journals and has written many books on helping people to change behavior. He is coauthor (with William R. Miller) of the classic work Motivational Interviewing: Helping People Change, now in its third edition. He has traveled worldwide to train practitioners in many settings and cultures, and now works as a trainer and consultant in health care and sports. His website is www.stephenrollnick.com.
 
William R. Miller, PhD, is Emeritus Distinguished Professor of Psychology and Psychiatry at the University of New Mexico. He introduced motivational interviewing in a 1983 article and in the first edition of Motivational Interviewing (1991), coauthored with Stephen Rollnick. Dr. Miller’s research has focused particularly on the treatment and prevention of addictions and more broadly on the psychology of change. He is a recipient of two career achievement awards from the American Psychological Association, the international Jellinek Memorial Award, and an Innovators Award from the Robert Wood Johnson Foundation, among many other honors. His publications include 65 books and over 400 articles and chapters. His website is https://williamrmiller.net.
 
Christopher C. Butler, MD, is Professor of Primary Care at the Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom, and Professorial Fellow at Trinity College. He is Clinical Director of the University of Oxford Primary Care Clinical Trials Unit, and chairs the Longitude Prize Advisory Panel. Dr. Butler was for many years a general practitioner in South Wales. He was named the Wales Royal College of General Practitioners patient-nominated GP of the Year in 2019 and received the Royal College of General Practitioners Research Paper of the Year Award in 2020. His main research interests are in common infections, and health care communication and behavior change. He has led, or helped lead, over 30 clinical trials and published over 400 peer-reviewed papers.
 
 
 

Table of Contents

Prologue 1

Part I Introduction to Motivational Interviewing 5

Chapter 1 Good Practice: The Compassionate Guide 7

Chapter 2 Motivational Interviewing 18

Part II Skills 29

Chapter 3 Asking 31

Chapter 4 Listening 38

Chapter 5 Affirming 46

Chapter 6 Summarizing 54

Part III Motivational Interviewing in Practice 61

Chapter 7 Connecting with a Person: Engaging 63

Chapter 8 Finding Direction: Focusing 78

Chapter 8 Addressing the Why and How of Change: Evoking 93

Chapter 10 Heading Into Action: Planning 105

Part IV Everyday Challenges 117

Chapter 11 Offering Advice and Information 119

Chapter 12 MI Briefly 128

Chapter 13 MI and Assessment 134

Chapter 14 MI in Groups 140

Chapter 15 MI Remotely 149

Chapter 16 MI for Health Care Administrators and Managers 156

Part V Inside Motivational Interviewing 165

Chapter 17 Vaccine Hesitancy: A Case Example 167

Chapter 18 MI in Depth: "What Would You Say Next?" 177

Appendix A Practitioner's Guide to MI Research 187

References 195

Index 211

Interviews

Physicians in all specialties, nurses, and a broad range of other health care professionals. May serve as a supplemental text in such courses as Introduction to Clinical Medicine and Medical Interviewing.

Editorial Reviews

The book provides an excellent description of state-of-the-art patient-centered communication for both newbies and established practitioners who are looking for a refresher in MI spirit.” (on the first edition)

American Journal of Lifestyle Medicine

Motivational Interviewing in Health Care offers a new approach in communicating for nurses—particularly providers treating patients with chronic diseases such as diabetes and obesity—and all health care professionals working to assist patients in making lifestyle changes for better health....As information technology relentlessly invades the realm of patient care, we find ourselves with less time to communicate with and teach our patients, so the time we do have must be optimized....Provides many examples of MI conversations, giving the reader insight into how MI communication works.” (on the first edition)

Registered Nurse

"Whether you are a health care professional-in-training or an experienced practitioner, this book is for you! The second edition is chock-full of information on current everyday challenges in a busy practice, including medication adherence, pain management, vaccine hesitancy, weight loss, addressing multiple behavior changes, working with hostile patients, and using MI remotely. The book weaves together the spirit of MI and micro-skills with newer processes of engaging, focusing, evoking, and planning, which are essential to facilitating behavior change. Highlights include practitioners’ reflections, practical exercises, annotated clinical scenarios, and sample open-ended questions for each process. This book can help you rediscover the joys of clinical work and prevent burnout by using MI to create more satisfying, efficient, and effective patient conversations."—Melanie A. Gold, DO, DMQ, Professor of Pediatrics and Population and Family Health, Columbia University Irving Medical Center

"We use this book as one of the texts in our Advanced Health Promotion and Disease Prevention course, which introduces MI skills to advanced practice registered nurses. The students learn to see patients as people first, and to achieve better outcomes by using partnership, acceptance, compassion, and empowerment. The text has simple instructions with practical tools for application. This book fits into the classroom and practice setting as a resource for many health care disciplines."—Melanie Markham, MSN-ED, RN, Adjunct Faculty, School of Nursing, Regis College

“Health care has been stuck in the ‘righting reflex,’ trying to fix patients by projecting science onto them. But to truly shift towards healthy outcomes, patients want our hearts and our ears before our science. This book guides us toward a process of care that is more effective for those we serve and more rewarding for ourselves. The second edition thoroughly updates this classic resource for delivering value-based care."—David Rakel, MD, Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health

“Full of helpful tips to help clinicians guide their patients to achieve better health outcomes. I have been using the principles of MI since I first had the pleasure to learn this impactful approach more than 20 years ago. Each section of the book describes a step in the journey of helping people change their behavior by having constructive conversations during brief clinical visits. The second edition revisits and refines MI techniques in a practical, teachable format. All providers should become familiar with these critical elements of behavior change.”—Robert A. Gabbay, MD, PhD, FACP, Chief Scientific and Medical Officer, American Diabetes Association; Associate Professor of Medicine, Harvard Medical School

"Rollnick, Miller, and Butler do a terrific job of breaking down MI skills for students and practitioners using MI for health behavior change. The case examples are a wonderful tool to help the reader understand key concepts. In all aspects of health care, we come across clients who could benefit from changing behaviors, and this book is instrumental as a guide. In the second edition, I especially enjoyed the new chapter on MI for administrators and managers and the case study on vaccine hesitancy."—Toby Spiegel, PsyD, School of Health Sciences, California Southern University of Health Sciences

"An essential handbook for any practitioner who strives to have a positive impact on people's health and well-being. Written with the busy clinician in mind, this second edition guides you through the spirit and skills in a way that makes MI feel accessible and easy to implement in high-pressure environments. I will keep this book by my side in every meeting with clients. I cannot think of a single area in health care where this book would not be needed."—Orla Adams, MSc, primary care dietitian, Cardiff and Vale University Health Board, United Kingdom; member, Motivational Interviewing Network of Trainers (MINT)

"As an internist, when I first learned MI, a colleague suggested that I try it with patients who had uncontrolled diabetes or hypertension, the bread and butter of my practice. Only then did I see the opportunity to sprinkle MI into every primary care interaction. This wonderful book provides scenarios relevant to diverse medical specialties and settings, helping clinicians to immediately apply the spirit, processes, and powerful skills of MI. It provides timely insights into using MI remotely, in groups, and to address vaccine hesitancy. The case studies in the final section pull it all together and challenge learners to think about how they would respond and what they would say, thus preparing them to hit the ground running with their own patients."—Damara Gutnick, MD, Departments of Family and Social Medicine; Psychiatry and Behavioral Sciences; and Epidemiology and Population Health, The Albert Einstein College of Medicine

"In its second edition, this is a 'must-have' text for graduate health and human services students who want to communicate effectively with their patients/clients for positive outcomes. The text will be especially helpful for interprofessional education courses on communication skills, as there are various health care setting examples along with sample dialogue and practice exercises. The book is also for experienced practitioners who want to stay abreast of the current thinking and practice of MI. Rollnick, Miller, and Butler have written a book that is delightful to read, clear, concise, and addresses current topics such as using MI remotely and MI and vaccine hesitancy."—Melinda Hohman, PhD, MSW, School of Social Work (Emeritus), San Diego State University

From the Publisher

I highly recommend this book to directors of clinical services, analysts, therapists of all disciplines, and students. It has survived my usual skepticism for ‘new’ approaches and has inspired me to seek training and supervision in MI.” (on the first edition)

Bulletin of the Menninger Clinic

This book is an excellent introduction to MI and has been written to help clinicians integrate this guiding style into their practice. It is crammed with techniques and draws on a wide range of clinical material to illustrate how they can be used....Although not explicitly written for work with adolescents, there is a great deal of useful and relevant material. This is a highly readable book and an excellent resource both for novice and experienced MI practitioners.” (on the first edition)

Child and Adolescent Mental Health

Practitioners such as nurses, the largest group of health care providers, will welcome the opportunity to add MI to their toolkits....Recommended.” (on the first edition)

Choice Reviews

Provides practical guidance on how clinicians in health care settings can apply MI to promote change in a range of health-related behaviors....Has the potential to make an important long-term impact on both individual and population health outcomes.” (on the first edition)

Drug and Alcohol Review

Will prove useful for practice nurses, health visitors, occupational therapists, physiotherapists, general practitioners, and mental health professionals....Excellent.” (on the first edition)

Nursing Standard

This book is a helpful tool for all practitioners seeking a better commitment to behavior change in their patients. The skill set needed to accomplish the goal of behavior change is already developed in most clinicians. This book guides the reader through the process of honing those skills and switching effortlessly through the various methods of patient interaction to best achieve change.” (on the first edition)
 

Journal of Chronic Obstructive Pulmonary Disease

"There are useful chapters on asking, listening, and informing skills that begin with general comments and then focus on specific skills and strategies for MI. The chapters are well illustrated with examples of dialogue from different settings....A number of case studies are given that relate ways in which health services is resonant with the respectful and collaborative nature of MI....The book has value for family physicians, general practitioners, and registrars who are interested in improving their communication skills, particularly in the area of brief behaviour change counselling. The simple yet powerful concepts regarding communication styles and skills will also be useful for teachers of communication skills."

South African Family Practice Journal

"The authors are leading authorities in motivational interviewing, having founded, developed, and written extensively on the topic over the past 25 years....For a broad range of frontline clinicians, including those who work in various medical specialties, the book gives useful insights that can have an immediate impact by making one's practice more productive and more enjoyable. For those with special interest in human behavior, particularly those in the mental health field, this book is a concise, highly readable introduction to motivational interviewing and will likely pique interest for further study of this powerful tool for promoting change."

Psychiatric Services

"This book represents the latest thinking from the principal architects and researchers of Motivational Interviewing (MI)....This book is an excellent introduction to MI and has been written to help clinicians integrate this guiding style into their practice. It is crammed with techniques and draws on a wide range of clinical material to illustrate how they can be used....Although not explicitly written for work with adolescents, there is a great deal of useful and relevant material. This is a highly readable book and an excellent resource both for novice and experienced MI practitioners."

Child and Adolescent Mental Health Journal

The book will be of interest to any community health nurse who interacts with patients, in particular those who try to help clients manage chronic illnesses such as diabetes and high blood pressure. The authors provide a detailed framework for guiding behavioral change and offer a map for shifting interview styles with comfort, so that the practitioner can adopt the appropriate style for the client situation. This title is also suitable for adoption in classes and clinical labs that are focused on teaching students about helping relationships and about strategies for assisting patients to make a positive lifestyle change.”

Journal of Community Health Nursing

"Practitioners such as nurses, the largest group of health care providers, will welcome the opportunity to add MI to their toolkit....Recommended."

Choice

Reviewer: Gary B Kaniuk, PsyD (Cermak Health Services)
Description: This book describes motivational interviewing, a concept developed in 1983 in order to help increase patient motivation and enhance behavioral change. Though initially used in dealing with alcoholism, motivational interviewing is now being used with other medical and psychological problems.
Purpose: As stated in the preface, "the book is for any health care practitioner who spends time encouraging patients to consider behavior change." Later, in chapter one, the authors note, "This book was written to help you have productive conversations with patients about behavior change. In particular, we describe a gentle form of counseling known as motivational interviewing, which has been found effective in fostering change across a wide range of health behaviors."
Audience: The target audience is broad, including nurses, doctors, dieticians, psychologists, counselors, health educators, dentists, dental hygienists, social workers, physical and occupational therapists, podiatrists, and "sometimes even people who answer the office telephones," according to the authors. All of the authors have published extensively. Dr. Rollnick is professor of health care communications at Cardiff University, Dr. Miller is emeritus distinguished professor of psychology and psychiatry at the University of New Mexico, and Dr. Butler is professor of primary care medicine and head of the Department of Primary Care and Public Health at Cardiff University.
Features: The four guiding principles of motivational interviewing are: to resist the righting reflex; to understand and explore the patient's own motivations; to listen with empathy; and to empower the patient, encouraging hope and optimism. Motivational interviewing has been shown effective with substance abuse and other physical and psychological disorders such as cardiovascular disease, diabetes, diet, hypertension, psychosis, pathological gambling, and HIV infection. This book is a step-by-step approach to learning motivational interviewing and it begins with theory, presents the core skills, and then shows how to integrate these skills in a clinical setting. Chapter eight is wonderful in presenting three case studies on how to use the method. There are also clinical examples in other chapters as well. Other nice features are the epilogue, which provides more information on the process, appendix A, aids to learning, and appendix B, a topical bibliography. The bibliography is helpful because readers can turn right to the disorder they want more research/information on. The book is easy to read and practical and the tables and figures are instructional. This is the kind of book that you can read and use the information soon after in a clinical situation. However, appendix A does contain dozens of references for more training in motivational interviewing.
Assessment: This is a practical, easy to read book that is useful with both psychiatric and physical disorders. It has a solid research base since its development in 1983. Though concise, it can help clients consider making important behavioral changes in their lives which can affect both their psychological and physical functioning. Healthcare providers will find it to be a welcome addition to their libraries, both in terms of having another set of techniques to assist clients and because of its low cost.

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